NPIMap

Organization Active NPI

Reza M. Birjandi DDS., a Professional Dental Corporation

  • Dentist
  • Sun City, CA
National Provider Identifier
1245512649
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38259 Issued in CA
Legal business name
REZA M. BIRJANDI DDS., A PROFESSIONAL DENTAL CORPORATION
Practice address
28401 Bradley Rd
Suite C
Sun City, CA 92586-3040
Phone
(951) 679-0691
Fax
(951) 679-6094
NPI assigned
Sep 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Esbeidy Lomeli
Title
Office Manager
Phone
(951) 679-0691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 38259 CA Primary

Addresses

Primary practice location

28401 Bradley Rd
Suite C
Sun City, CA 92586-3040

Mailing address

28401 Bradley Rd
Suite C
Sun City, CA 92586-3040
Phone (951) 679-0691

Other identifiers 1

IdentifierTypeStateIssuer
G94101-02OtherCAMEDICAL

National Provider Directory

National Provider Directory
Tax ID family
Reza M Birjandi DDS a Professional Dental Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

28401 Bradley Rd
Ste C
Sun City, CA 92586
Phone (951) 679-0691

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571097600000",
    "number": "1245512649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28401 BRADLEY RD",
            "address_2": "SUITE C",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925863040",
            "telephone_number": "951-679-0691",
            "fax_number": "951-679-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28401 BRADLEY RD",
            "address_2": "SUITE C",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925863040",
            "telephone_number": "951-679-0691",
            "fax_number": "951-679-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REZA M. BIRJANDI DDS., A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2019-10-15",
        "status": "A",
        "authorized_official_last_name": "LOMELI",
        "authorized_official_first_name": "ESBEIDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "951-679-0691",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "38259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "G94101-02",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.